This guest opinion is by Mel Kohn, M.D., state epidemiologist in the Public Health programs of the Oregon Department of Human Services.

Word count: 563 words

By Mel Ko​hn, M.D.

As Oregonians, many of us are proud to live in a state that is often on the cutting edge -- whether it's open beaches, independent living for seniors or recycling programs. Yet when it comes to preventing tobacco use, we are in danger of being left in the dust -- or, perhaps more accurately, in a haze of secondhand smoke.

According to newly released data from the Campaign for Tobacco Free Kids, Oregon ranks 35th nationally in funding to keep kids from smoking and helping people to quit tobacco.

Only a few years ago, Oregon's tobacco prevention and education program was a national model of effectiveness. In 1996, Oregon voters approved a 30-cent increase in cigarette taxes, designating 10 percent of that for tobacco prevention and education. From 1996 to 2003, the share of adults who smoke dropped from 24 percent to 21 percent.

And many of those who continued to smoke did so less, leading to a 40 percent drop in per-capita tobacco consumption --almost twice that seen nationally.

In 2003, the Legislature cut funding for Oregon's prevention program to less than half the 1996 voter-approved amount. Currently, the program is funded at less than one-sixth of the minimum level recommended by the federal Centers for Disease Control and Prevention (CDC).

Among the Western states, Oregon has fallen behind California, Nevada and Washington, only surpassing Idaho in tobacco prevention funding.

We've fallen behind in another way, as well. In 2001, the Legislature passed a law banning smoking in many indoor workplaces. This was a step forward, but the law has large loopholes: It exempts bars, bowling alleys, bingo parlors and restaurants with a bar included. That means people working there are unprotected from secondhand smoke. The law also forbids citizens from working for stronger local laws.

Since then, the tobacco-prevention movement, both nationally and internationally, has moved ahead -- but Oregon has not kept pace. For example, in November Washington became the 10th state to make all workplaces smokefree. In protecting all workers, it joins states such as California, New York, Delaware and Massachusetts and countries such as Uganda, New Zealand and Ireland.

Yes, even Irish pubs are now smokefree! But in Oregon, those who work in or patronize exempt businesses are often exposed to dangerous levels of secondhand smoke.

Recent CDC data show that Americans are smoking less. That's good news: Fewer smokers means less lung cancer, less heart disease, fewer SIDS deaths and less respiratory disease among children of smokers. It also means lower health care costs and more years of productive life.

These data also show that states committed to tobacco prevention make the most progress, and states with little or no tobacco-prevention funding lag behind. In Oregon, the effect of reduced funding is reflected in a slowdown in the decline of cigarette use.

Regaining our leadership in tobacco prevention and education is well within our reach. Adequate funding for community and school programs and strong laws limiting smoking in all workplaces can jumpstart our efforts and lead to further dramatic declines in smoking.

The evidence is clear -- we can reduce smoking and the death and disease that follow. We've already shown we know what to do and how to do it. The only question remaining is whether we have the will.

Mel Kohn, M.D., is state epidemiologist in thePublic Health programs of the Oregon Department of Human Services.